Seyi-Olajide Justina O, Gerk Ayla, Guadagno Elena, Ademuyiwa Adesoji, Ameh Emmanuel A, Poenaru Dan
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
J Pediatr Surg. 2025 Apr;60(4):162192. doi: 10.1016/j.jpedsurg.2025.162192. Epub 2025 Jan 28.
An estimated 1.7 billion children, mostly in low- and middle-income countries, lack access to surgical care. Increased focus on, and investment in, children's surgery requires the deliberate and strategic inclusion of children's surgery in healthcare policies. Here we evaluate the status of children's surgical diseases in Nigeria's healthcare policies.
Key Nigerian policy documents referring to child and adolescent health were identified and analyzed using Collins' 8-step framework for health policy analysis. The search for evidence (3rd step in Colin's framework) included a combination of directed (DCA) and conventional content analysis (CCA). DCA was based on 4 categories (workforce, service delivery, infrastructure and financing) obtained from the surgical systems development framework developed by the Lancet Commission on Global Surgery.
Seven policy documents with child and adolescent health contents were reviewed: the National Child Health Policy (NCHP), National Policy on Development of Adolescents and Young People in Nigeria (NPDAYPN), Nigeria Every Newborn Action Plan (NENAP), Community Health Influencers Promoters and Services Programme (CHIPS), National Surgical Obstetrics Anaesthesia and Nursing Plan (NSOANP), National Guidelines for Comprehensive Newborn Care (NGCNC) and National Strategic Health Development Plan (NSHDP). Only the NSOANP had surgeons involved in its development, comprehensively addressed children's surgical conditions across all categories, and included surgical stakeholders in its implementation.
Children's surgery is not prioritized for specific inclusion within Nigeria's healthcare policies. There is a need for greater collaboration and integration into key healthcare policies. Prioritizing deliberate and strategic inclusion of children's surgery will ensure unmet surgical needs is addressed.
据估计，全球有17亿儿童无法获得外科治疗，其中大多数在低收入和中等收入国家。加大对儿童外科手术的关注和投入，需要在医疗政策中有意且策略性地纳入儿童外科手术。在此，我们评估尼日利亚医疗政策中儿童外科疾病的现状。
确定并分析了尼日利亚涉及儿童和青少年健康的关键政策文件，采用柯林斯健康政策分析的8步框架。证据检索（柯林斯框架的第3步）包括定向内容分析（DCA）和传统内容分析（CCA）相结合的方法。DCA基于《柳叶刀》全球外科委员会制定的外科系统发展框架中的4个类别（劳动力、服务提供、基础设施和融资）。
审查了7份包含儿童和青少年健康内容的政策文件：《国家儿童健康政策》（NCHP）、《尼日利亚青少年和青年发展国家政策》（NPDAYPN）、《尼日利亚每一位新生儿行动计划》（NENAP）、《社区健康影响者促进者和服务计划》（CHIPS）、《国家外科、产科、麻醉和护理计划》（NSOANP）、《综合新生儿护理国家指南》（NGCNC）和《国家战略健康发展计划》（NSHDP）。只有NSOANP在制定过程中有外科医生参与，全面涵盖了所有类别的儿童外科疾病状况，并在实施过程中纳入了外科利益相关者。
在尼日利亚的医疗政策中，儿童外科手术未被列为需要特别纳入的优先事项。需要加强合作并将其纳入关键医疗政策。优先考虑有意且策略性地纳入儿童外科手术将确保未满足的外科需求得到解决。
